THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to Your Privacy
Charisma Therapy Associates, PLLC ("we," "us," or "our") is dedicated to protecting the privacy of your protected health information (PHI). We are required by law to maintain the privacy of your PHI, provide this Notice of our legal duties and privacy practices, and abide by its terms.
How We May Use and Disclose Your Health Information
We may use or disclose your PHI, without your written authorization, for:
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Treatment — to provide, coordinate, or manage your therapy and related care
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Payment — to bill and obtain payment for services, including insurance claims
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Health Care Operations — for quality assessment, training, and business management
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As Required by Law — including mandatory reporting of abuse, neglect, or domestic violence, and in response to court orders
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Health and Safety — to prevent or lessen a serious and imminent threat to you or others
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Other Permitted Disclosures — such as public health activities or health oversight, as permitted by law
Uses Requiring Your Written Authorization
Other than as described above, we will not use or disclose your PHI without your written authorization — including most disclosures of psychotherapy notes and any use for marketing. You may revoke an authorization in writing at any time, except to the extent we've already relied on it.
Your Rights
You have the right to:
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Request restrictions on certain uses and disclosures of your PHI
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Request confidential communications by alternative means
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Inspect and copy your PHI, with certain exceptions
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Request amendment of your PHI
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Receive an accounting of certain disclosures
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Receive a paper copy of this Notice upon request
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Be notified in the event of a breach of your unsecured PHI
To exercise these rights, contact our office using the information below.
Website and Electronic Communications
If you contact us via our website, online forms, email, text, or client portal, please note that no method of electronic transmission is completely secure. We use reasonable safeguards to protect your information in accordance with HIPAA, but cannot guarantee absolute security. Please avoid sharing sensitive clinical details through non-secure channels like standard email or website forms.
Changes to This Notice
We reserve the right to change this Notice at any time. Updated versions will be posted on our website and made available at our office.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
Effective Date: 06/01/2020